An Annuity is a kind of insurance

Buzz and I were taking a look at Exam counts the other day and noticed that the most productive OD's in the company see medical exams as a very high percentage of routine exams.  For example one OD while seeing an average of 9.2 routine patients per day adds 5.4 medical visits per day to that total.  Buzz comment: "Seems like medical visits are (or can be) an annuity to a practice."

Properly managed most patients with chronic eye problems or systemic problems with ocular implications (e.g. diabetes, glaucoma, rheumatoid arthritis, dry eye) should be back into the office on a regular basis -- forever or until they either die or move away. If you think about it getting ALL patients returning because of a disease condition that needs to be managed or just for routine eye care should result in a practice the grows and grows and grows and grows -- that's the annuity.

So, why does this not happen in ALL practices?  Some things that may be at work that we see all the time in chart reviews:

1. Being on Automatic Pilot --- everyone gets an annual exam. This results in:
   
2. Failure to order necessary tests and follow up  -- missing the opportunity to serve the patient at a high level.
   
3. Failure to educate the patient as to the reason why it is important that they return  - causing no-shows
   
4. Failure to enter a recall or an appointment in the system.
5. Failure to follow up on a "no show."

I am sure that they are others.  What are you doing to make certain that patients return?  How do you educate the patient so that they understand how important it is that they return for ancillary testing and visits so that you can properly care for them?  How do you create an annuity?